I don’t think that QT was designed to work with those huge dimensions. That’s a lot of pixels. Subdividing / reducing the image, depending on your needs, might help.
I think the QT limitation does not apply to other ‘real’ image manipulation software, like gimp, photoshop, or equivalents. I think that instead of creating a big image, you should subdivide it into 4, write them to disk, then call the external software to get them back together into a single file.
I think I would use ImageMagick to do that, because it’s ‘easy’ to use in command line.
As a note : I use QT extensively, and I’d like to participate in the implementation. But this kind of development is new to me, and I feel lost about what to do/where to begin. If you have any advice about this, do not hesitate to send me a PM.